In the surgery of the eyeball of the human body, the surgical lens is indispensable in order to secure an excellent surgical field. Hereinafter, the surgical lens will be explained with reference to FIG. 12, FIGS. 13(A) and (B), and FIG. 14, taking a case of the vitreous body surgery, which is typical ophthalmologic surgery, as an example.
Incidentally, the same symbols and numerals are assigned to corresponding parts in FIG. 1 to FIG. 14.
In the vitreous body surgery, first of all, as shown in FIG. 12, an upper eyelid 110 and a lower eyelid 120 of an eyeball 100 of a patient laid on its back are pulled upward and downward respectively to be opened using eyelid openers 10.
Next, a surgical lens 50 is held in a desired position on the eyeball 100 whose eyelids are opened. However, since the eyeball 100 is substantially spherical, the surgical lens 50 is needed to be held so as not to slip down the eyeball.
Thus, as shown in FIG. 12, a surgical lens holding portion 30 (hereinafter referred to as lens ring 30) having a ring shape is conventionally stitched to a sclera 130 (the white part of the eyeball) on the eyeball 100 using a suture 60 in order to hold the surgical lens 50 on the eyeball.
This stitching will be further detailed using FIGS. 13(A) and (B), and FIG. 14.
FIG. 13(A) is a case in which the lens ring 30 having two stitching and engaging portions 35 is stitched on the eyeball 100, FIG. 13(B) is a case in which the lens ring 30 having four stitching and engaging portions 36 and 37 is stitched on the eyeball 100, and FIG. 14 is a cross-sectional view taken along the C-C line in the case.
Here, as shown in FIGS. 13(A) and (B), the lens ring 30 has a diameter larger than that of a cornea 131 and is held on the sclera 130. As the suture 60 for stitching the lens ring 30 on the sclera 130, a 5-0 Dacron suture or a 7-0 silk suture is used.
A surgeon passes the suture 60 into a surgical needle as in the example shown in FIG. 13(A), passes the surgical needle in such a manner as to scoop up an upper half layer of the sclera 130 as shown in FIG. 14, and bridges the suture 60 over the stitching and engaging portions 35 to stitch the lens ring 30 on the eyeball 100.
The example shown in FIG. 13(B) is a stitching method in a case in which the lens ring 30 is detachable.
The surgeon passes the suture 60 into the surgical needle, passes the surgical needle in such a manner as to scoop up the upper half layer of the sclera 130 as shown in FIG. 14 along the circumference of the lens ring 30 to fix the stitching and engaging portions 36 and 37, and finally ties a temporary knot 61 of the suture 60. When the lens ring 30 is detached, the temporary knot 61 is untied and the suture 60 is loosened to remove the suture from the stitching and engaging portions 36 and 37. When the lens ring 30 is stitched again, the suture 60 is bridged over the stitching and engaging portions 36 and 37 and then the temporary knot 61 is tied again to fix the stitching and engaging portions 36 and 37 so that the lens ring 30 is stitched in the desired position again.
When the stitching of the lens ring 30 on the eyeball 100 is completed in the above-described way, as shown in FIG. 12, the surgeon inserts a scalpel into the eyeball 100 and a light guide 80 for illuminating the surgical field, a vitreous body cutter 70 for cutting and sucking the vitreous body in the eyeball 100, an infusion 90 for injecting perfusate of an equivalent quantity to the quantity of the sucked vitreous body, and so on are inserted into the eyeball 100 to perform interocular surgery.
In FIG. 12, above the surgical lens 50, a not-shown surgical microscope is set and the surgeon performs the surgery while observing the surgical field through the surgical microscope and the surgical lens 50. If it is required to observe a different surgical field as the surgery progresses, the surgical lens 50 is appropriately rotated using a swab 75 or a fingertip and the like or replaced by the surgical lens 50 having a different shape, or the stitching position of the lens ring 30 is changed as described above.
It has been made to be clear by the inventors that, in the interocular surgery performed as described above, there are following problems.
To begin with, a first problem is that the passing the surgical needle in such a manner as to scoop up the upper half layer of the sclera 130 is an operation requiring the greatest care and time even for a skilled surgeon. Moreover, since this stage is a preparatory stage for the interocular surgery, imposing a burden of paying attention on the surgeon and consuming the time in this stage are greatly disadvantageous to the subsequent interocular surgery.
Further, a second problem is that, even if the skilled surgeon pays close attention, in case the surgical needle penetrates the sclera 130, tissues under the sclera are damaged, which may cause a complication after the surgery.
A third problem is that, even if the surgery needle does not penetrate the sclera 130, it is obvious that the surgical needle and the suture 60 are invasive for the sclera 130.
A fourth problem is that, since the lens ring 30 is fixed on the eyeball 100, every time when the lens ring 30 interferes with a surgical operation as the surgery progresses, the lens ring 30 is needed to be detached by cutting the suture 60 or by untying the temporary knot 61 to loosen the suture 60 and the first to third problems are repeated.
For example, in so-called triple surgery, in which three types of surgery, that is, ultrasonic surgery for emulsifying and sucking crystalline lens, retina and vitreous body surgery, and surgery for inserting an interocular lens are performed at the same time, the surgery progresses in the order of, for example, () ultrasonic emulsification and suction of the crystalline lens, () vitreous body surgery, () interocular lens insertion, and () air displacement and interocular light solidification, and the surgical lens 50 is necessary in the stages of () and () while the surgery cannot be performed if the surgical lens 50 and the lens ring 30 are stitched on the eyeball 100 in the stage of (). As a result, it is required to detach the lens ring 30 by cutting or loosening the suture 60 when the stage goes from () to () and to stitch the lens ring 30 again when the stage goes from () to ().
A fifth problem is that, since the lens ring 30 is fixed on the eyeball 100, there is a part which cannot be observed even if the surgical lens 50 is rotated or replaced as described above.
In this case, conventionally, the surgical lens 50 is slightly tilted in the lens ring 30 to perform observation, but it is difficult to finely adjust the tilt.
As a result of dedicated study in order to solve the aforesaid problems, the inventors have thought that the problems can be solved all at once if the lens ring 30 is connected to the eyelid openers 10, not to the eyeball 100.